Evaluation of the usefulness of NaF-PET in diagnosis of bone metastases from thyroid cancer in comparing with that of conventional Tc-99m-diphosphonate bone scintigraphy

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Bone metastases from differentiated thyroid carcinoma (DTC) are sometimes difficult to visualize on bone X-ray films. Conventional Tc-99m-diphosphonates bone scintigraphy (CBS) IS used for detecting bone metastases of DTC. 18F-NaF has been used in PET as a bone seeking agent. We evaluated the effectiveness of NaF-PET in comparison with CBS for the diagnosis of bone metastases in DTC. Diagnostic abilities of F-18 NaF-PET and CBS were examined visually based on the following criteria : ability to distinguish lesions from normal bone structure ; visual resolution ; and ability to distinguish uptake metastases and osteoarthritis in the ROIs. The overall accuracy of bone PET was higher in all subjects. CBS was accurate in distinguishing lesions from normal bone. but did not perform well in the other two criteria. Quantitative evaluation of the ratio of normal to metastatic bone was significantly different in PET studies but not in CBS studies of osteoarthritis.